目的: 台灣地區剖腹產率持續偏高，其背後隱含了台灣醫療現況與民眾觀念之諸多現象。雖有各項措施與建議，但至今剖腹產率仍維持在35%以上，明顯高於其他國家。有鑑於「非醫療因素」對剖腹產有重要影響及目前醫療市場之消費特性，本研究以「路徑分析」探討孕婦選擇生產方式之行為模式，提供國內控制剖腹產率之短期、長期策略建議，並有效控制剖腹產率。
方法：本研究以橫斷式研究，針對中部地區醫療院所，以結構式問卷對第三孕期收案孕婦調查其產前之剖腹產傾向與相關非醫療因素，以路徑分析之方法分析並驗證各變項之間的直接、間接與路徑效果，再以「路徑圖」呈現孕婦選擇剖腹產的行為路徑。
結果：研究結果得到以下五條顯著意義之路徑（依顯著程度排列）
1、孕婦對美觀的態度會直接影響其對剖腹產之傾向
2、孕婦的生產史會經由剖腹產強化訊息間接影響其對剖腹產傾向
3、孕婦的年齡會經由剖腹產強化訊息間接影響其對剖腹產之傾向
4、孕婦的年齡會經由經濟收入間接影響其對剖腹產之傾向
5、孕婦的年齡會經由教育程度及經濟收入間接影響其對剖腹產之
傾向
結論：現今台灣地區一般大眾仍認為剖腹產是較好的生產方式，認為自然產的很多風險或後遺症可用剖腹產解決。而社會環境給予剖腹產的孕婦太好的福利，使得前胎剖腹產或少胎次的孕婦傾向選擇剖腹產; 同時醫療環境也未能提供孕婦足夠的自然產信心，使得年輕孕婦更容易因非醫療因素而傾向選擇剖腹產。
Objective: Cesarean section rate in Taiwan remained high, which was hidden behind the medical and social phenomena, significantly higher than other countries. Considering consumption characteristics of current health care market and the influence of "non-medical factors" on cesarean section rate, this study applied “Path Analysis” to explore the behavior of pregnant women choose delivery mode. Wish to effectively control the cesarean section rate in Taiwan by supply short term, long-term strategy recommendations.
Methods: In this cross-sectional study, third trimester pregnant women from medical institutions of different levels in central Taiwan region were enrolled. A structured questionnaire was used to investigate their prenatal
Cesarean tendency and related non-medical factors. Analysis and verification the direct, indirect and path effect by path analysis, showing the behavior model of pregnant women choose Cesarean Section by path diagram.
Results: Five significant paths were verified after analysis.
1. Beautiful attitude may directly influence Cesarean
tendency.
2. Obstetric history may indirectly influence Cesarean
tendency via Cesarean positive reinforcement message .
3. Age may indirectly influence Cesarean tendency via
Cesarean positive reinforcement message .
4. Age may indirectly influence Cesarean tendency via health
confidence and income.
5. Age may indirectly influence Cesarean tendency via health
confidence, income, and educational attainment .
Conclusion: The general publics in Taiwan today still believe that Cesarean section is the better mode of delivery. They though that many risks or complications of delivery can be solved by Cesarean section. More benefits for cesarean section in our society makes previous
caesarean women or less parity women tend to choose Cesarean section. Young pregnant women tend to choose Cesarean section more easily by non-medical factors due to ourey medical environment failed to provide them enough confidence of vaginal delivery.
